A case with recurrent idiopathic anaphylaxis episodes starting soon after COVID-19 mRNA vaccination
Main Article Content
Keywords
COVID-19 Vaccine, Idiopathic Anaphylaxis, Omalizumab
Abstract
Introduction: A patient was presented with a history of idiopathic recurrent anaphylaxis after administration of Pfizer BioNTech mRNA vaccine, and the attacks were controlled with omalizumab. To our knowledge, this is the first reported case of recurrent idiopathic anaphylaxis (IA) after administration of Pfizer BioNTech mRNA vaccine.
Case Presentation: A 52-year-old man with recurrent episodes of IA after COVID-19 vaccination presented to our adult Allergy and Immunology Clinic. In the patient, urticaria and anaphylaxis episodes could not be controlled with high-dose antihistamine and systemic steroid treatment, and complete control was achieved with omalizumab treatment and anaphylaxis attacks completely regressed.
Conclusion: In cases of unexplained or recurrent anaphylaxis in adult patients, COVID-19 vaccination and timing should be questioned, and its association with anaphylaxis might be considered.
References
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21 Thomas J, Thomas G, Chatim A, Shukla P, Mardiney M. Chronic spontaneous urticaria after COVID-19 vaccine. Cureus. 2021;13(9):e18102. 10.7759/cureus.18102
22 Dreyfus DH, Fraser B, Randolph CC. The syndrome of thyroid autoimmunity and idiopathic chronic urticaria and angioedema presenting as anaphylaxis. Allergy Asthma Proc. 2003;24(3):171–4.
23 Sanchez J, Ramirez R, Diez S, Sus S, Echenique A, Olivares M, Cardona R. Omalizumab beyond asthma. Allergol Immunopathol (Madr). 2012;40(5):306–15. 10.1016/j.aller.2011.09.011
24 Jendoubi F, Gaudenzio N, Gallini A, Negretto M, Paul C, Bulai Livideanu C. Omalizumab in the treatment of adult patients with mastocytosis: A systematic review. Clin Exp Allergy. 2020;50(6):654–61. 10.1111/cea.13592
25 Demirturk M, Gelincik A, Colakoglu B, Dal M, Buyukozturk S. Promising option in the prevention of idiopathic anaphylaxis: Omalizumab. J Dermatol. 2012;39(6):552–4. 10.1111/j.1346-8138.2012.01520.x
26 Jagdis A, Vadas P. Omalizumab effectively prevents recurrent refractory anaphylaxis in a patient with monoclonal mast cell activation syndrome. Ann Allergy Asthma Immunol. 2014;113(1):115–6. 10.1016/j.anai.2014.05.001
27 Lee J. Successful prevention of recurrent anaphylactic events with anti-immunoglobulin E therapy. Asia Pac Allergy. 2014;4(2):126–8. 10.5415/apallergy.2014.4.2.126
28 Pitt TJ, Cisneros N, Kalicinsky C, Becker AB. Successful treatment of idiopathic anaphylaxis in an adolescent. J Allergy Clin Immunol. 2010;126(2):415–6. 10.1016/j.jaci.2010.05.043
2 Fiolet T, Kherabi Y, MacDonald CJ, Ghosn J, Peiffer-Smadja N. Comparing COVID-19 vaccines for their characteristics, efficacy and effectiveness against SARS-CoV-2 and variants of concern: A narrative review. Clin Microbiol Infect. 2022;28(2):202–21. 10.1016/j.cmi.2021.10.005
3 Hause AM, Baggs J, Marquez P, Abara WE, Olubajo B, Myers TR, et al. Safety monitoring of COVID-19 vaccine booster doses among persons aged 12–17 years–United States, December 9, 2021 to February 20, 2022. MMWR Morb Mortal Wkly Rep. 2022;71(9):347–51. 10.15585/mmwr.mm7109e2
4 Muraro A, Roberts G, Worm M, Bilo MB, Brockow K, Fernandez Rivas M, et al. Anaphylaxis: Guidelines from the European Academy of Allergy and Clinical Immunology. Allergy. 2014;69(8):1026–45. 10.1111/all.12437
5 Sampson HA, Munoz-Furlong A, Campbell RL, Adkinson NF, Jr., Bock SA, Branum A, et al. Second symposium on the definition and management of anaphylaxis: Summary report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium. J Allergy Clin Immunol. 2006;117(2):391–7. 10.1016/j.jaci.2005.12.1303
6 Simons FE, Ardusso LR, Bilo MB, El-Gamal YM, Ledford DK, Ring J, et al. World Allergy Organization anaphylaxis guidelines: Summary. J Allergy Clin Immunol. 2011;127(3):587–93.e1-22. 10.1016/j.jaci.2011.01.038
7 Lieberman P, Nicklas RA, Oppenheimer J, Kemp SF, Lang DM, Bernstein DI, et al. The diagnosis and management of anaphylaxis practice parameter: 2010 update. J Allergy Clin Immunol. 2010;126(3):477–80.e1-42. 10.1016/j.jaci.2010.06.022
8 Motosue MS, Bellolio MF, Van Houten HK, Shah ND, Campbell RL. Risk factors for severe anaphylaxis in the United States. Ann Allergy Asthma Immunol. 2017;119(4):356–61.e2. 10.1016/j.anai.2017.07.014
9 Worm M, Francuzik W, Renaudin JM, Bilo MB, Cardona V, Scherer Hofmeier K, et al. Factors increasing the risk for a severe reaction in anaphylaxis: An analysis of data from The European Anaphylaxis Registry. Allergy. 2018;73(6):1322–30. 10.1111/all.13380
10 Chung EH. Vaccine allergies. Clin Exp Vaccine Res. 2014;3(1):50–7. 10.7774/cevr.2014.3.1.50
11 Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. 2020;383(27):2603–15. 10.1056/NEJMoa2034577
12 Caubet JC, Ponvert C. Vaccine allergy. Immunol Allergy Clin North Am. 2014;34(3):597–613, ix. 10.1016/j.iac.2014.04.004
13 McNeil MM, DeStefano F. Vaccine-associated hypersensitivity. J Allergy Clin Immunol. 2018;141(2):463–72. 10.1016/j.jaci.2017.12.971
14 Selvaraj G, Kaliamurthi S, Peslherbe GH, Wei DQ. Are the allergic reactions of COVID-19 vaccines caused by mRNA constructs or nanocarriers? Immunological Insights. Interdiscip Sci. 2021;13(2):344–7. 10.1007/s12539-021-00438-3
15 Chang SE, Feng A, Meng W, Apostolidis SA, Mack E, Artandi M, et al. New-onset IgG autoantibodies in hospitalized patients with COVID-19. Nat Commun. 2021;12(1):5417. 10.1038/s41467-021-25509-3
16 Wang EY, Mao T, Klein J, Dai Y, Huck JD, Liu F, et al. Diverse functional autoantibodies in patients with COVID-19. Nature. 2021;595(7866):283–8. 10.1038/s41586-021-03631-y
17 Jaycox JR, Lucas C, Yildirim I, Dai Y, Wang EY, Monteiro V, et al. SARS-CoV-2 mRNA vaccines decouple anti-viral immunity from humoral autoimmunity. Nat Commun. 2023;14(1):1299. 10.1038/s41467-023-36686-8
18 Zuberbier T, Abdul Latiff AH, Abuzakouk M, Aquilina S, Asero R, Baker D, et al. The international EAACI/GA(2)LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022;77(3):734–66. 10.1111/all.15090
19 Magen E, Yakov A, Green I, Israel A, Vinker S, Merzon E. Chronic spontaneous urticaria after BNT162b2 mRNA (Pfizer-BioNTech) vaccination against SARS-CoV-2. Allergy Asthma Proc. 2022;43(1):30–6. 10.2500/aap.2022.43.210111
20 Strahan A, Ali R, Freeman EE. Chronic spontaneous urticaria after COVID-19 primary vaccine series and boosters. JAAD Case Rep. 2022;25:63–6. 10.1016/j.jdcr.2022.05.012
21 Thomas J, Thomas G, Chatim A, Shukla P, Mardiney M. Chronic spontaneous urticaria after COVID-19 vaccine. Cureus. 2021;13(9):e18102. 10.7759/cureus.18102
22 Dreyfus DH, Fraser B, Randolph CC. The syndrome of thyroid autoimmunity and idiopathic chronic urticaria and angioedema presenting as anaphylaxis. Allergy Asthma Proc. 2003;24(3):171–4.
23 Sanchez J, Ramirez R, Diez S, Sus S, Echenique A, Olivares M, Cardona R. Omalizumab beyond asthma. Allergol Immunopathol (Madr). 2012;40(5):306–15. 10.1016/j.aller.2011.09.011
24 Jendoubi F, Gaudenzio N, Gallini A, Negretto M, Paul C, Bulai Livideanu C. Omalizumab in the treatment of adult patients with mastocytosis: A systematic review. Clin Exp Allergy. 2020;50(6):654–61. 10.1111/cea.13592
25 Demirturk M, Gelincik A, Colakoglu B, Dal M, Buyukozturk S. Promising option in the prevention of idiopathic anaphylaxis: Omalizumab. J Dermatol. 2012;39(6):552–4. 10.1111/j.1346-8138.2012.01520.x
26 Jagdis A, Vadas P. Omalizumab effectively prevents recurrent refractory anaphylaxis in a patient with monoclonal mast cell activation syndrome. Ann Allergy Asthma Immunol. 2014;113(1):115–6. 10.1016/j.anai.2014.05.001
27 Lee J. Successful prevention of recurrent anaphylactic events with anti-immunoglobulin E therapy. Asia Pac Allergy. 2014;4(2):126–8. 10.5415/apallergy.2014.4.2.126
28 Pitt TJ, Cisneros N, Kalicinsky C, Becker AB. Successful treatment of idiopathic anaphylaxis in an adolescent. J Allergy Clin Immunol. 2010;126(2):415–6. 10.1016/j.jaci.2010.05.043
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Published
Nov 1, 2024
Article Details
How to Cite
Korkmaz, P., Demir, S., Eyice Karabacak, D., Unal, D., & Gelincik, A. (2024). A case with recurrent idiopathic anaphylaxis episodes starting soon after COVID-19 mRNA vaccination. Allergologia Et Immunopathologia, 52(6), 58-61. https://doi.org/10.15586/aei.v52i6.1191
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Case Report
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
How to Cite
Korkmaz, P., Demir, S., Eyice Karabacak, D., Unal, D., & Gelincik, A. (2024). A case with recurrent idiopathic anaphylaxis episodes starting soon after COVID-19 mRNA vaccination. Allergologia Et Immunopathologia, 52(6), 58-61. https://doi.org/10.15586/aei.v52i6.1191